Assignment: Medicare Reimbursements

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Assignment: Medicare Reimbursements

Assignment: Medicare Reimbursements

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rate realized a loss. Furthermore, Medicare used the RBRVS rate schedule to provide incen- tives and penalties for certain medical specialties. Visits to primary care physicians resulted in favorable reimbursement, but visits to specialists resulted in unfavorable reimbursement.

The Balanced Budget Act (BBA) of 1997 reduced Medicare reimbursements to providers by $115 billion over five years (Ernst & Young 1997; see also exhibit 6.5 later in this chapter for details), established the Children’s Health Insurance Program (CHIP), and introduced the sustainable growth rate (SGR), a method used by Medicare to determine annual updates (increases) in payment for physician services. The Balanced Budget Refinement Act (BBRA) of 1999 provided approximately $16 billion in Medicare relief over five years after the govern- ment discovered that the BBA of 1997 had cut two to three times more than the $115 billion originally intended. The Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) Benefits Improvement and Protection Act (BIPA) of 2000 provided $35 billion in reimbursement relief over five years by increasing certain Medicare and Medicaid provider payments; adding preventive benefits and reducing beneficiary cost sharing under Medicare; and improving insurance options for low-income children, families, and seniors (HFMA 2000).

The Deficit Reduction Act (DEFRA) of 2005 achieved $8.3 billion in savings from Medicare and $4.7 billion in savings from Medicaid, including the SCHIP, over five years and addressed the calculation of a hospital’s disproportionate share adjustment (HFMA 2006).

The Tax Relief and Health Care Act of 2006 included provisions to prevent a 2007 cut in Medicare physician payments mandated under DEFRA of 2005 (AHA 2006).

In 2007, President George W. Bush signed into law the Medicare, Medicaid, and SCHIP Extension Act of 2007, which extended funding for SCHIP and provided a 0.5 percent Medicare payment increase for physicians.

In 2008, Congress overrode President Bush’s veto of the Medicare Improvements for Providers and Patients Act of 2008, which replaced a planned 10.6 percent cut in Medicare payments to physicians based on the SGR with a 1.6 percent increase in Medicare payment to physicians.

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